STDs: What to Know about HPV and Genital Warts

About 5.5 million people are infected in the United States every year with genital warts, which are caused by the human papillomavirus (HPV). HPV has become so common that it is estimated that 80 percent of sexually active people contract it at some point. Among people between the ages of 15 and 49, only one in four Americans has not had a genital HPV infection, though in most cases the virus is harmless and exhibits no symptoms.

Genital warts are spread through vaginal, anal, and oral intercourse. They can also be passed on to infants during childbirth.

Not always visible, the warts are soft and flat; they grow on the genitals, in the urethra, in the inner vagina, in the anus, or in the throat.

The warts often itch and, if allowed to grow, can block openings of the vagina, anus, or throat, causing discomfort.

Because genital warts can be microscopic and therefore unseen by the naked eye, they can easily be passed to sexual partners.

High-risk strains of HPV do exist and can cause cervical lesions, which, over a period of time, can develop into cervical cancer if untreated. Doctors can detect HPV lesions with annual Pap smears, which is why all sexually active women should have yearly Pap smears. The use of Pap smears has drastically reduced the incidence of cervical cancer.

The U.S. Federal Drug Administration has approved a vaccine against some of the types of HPV that cause 70 percent of cervical cancer and 90 percent of genital warts. Developed by Merck, the vaccine is called Gardasil, and health officials recommend that all girls and women between the ages of 9 and 26 be vaccinated. (No vaccine is currently available for boys and men, although a link between HPV and anal and penile cancer may exist.) But because this vaccine doesn’t protect against all types of HPV, women, especially those who have multiple partners, should continue to have yearly Pap tests, even if they have received the vaccine.

Doctors can treat genital warts in several ways, including topical medical creams, some of which require a prescription and some of which don’t.

Over-the-counter medications for other types of warts should not be used on the genitals.

In cases of either large or persistent warts, other treatments may include surgical removal, freezing using liquid nitrogen, or cauterization by electric needles. Because doctors have no cure for HPV, genital warts can reoccur, and the virus can remain in the person’s cells indefinitely, though often in a latent (or not active) state. Most people who have reoccurring genital warts have only one more episode. Even in rare cases of people with multiple reoccurrences, the body’s immune system usually develops immunity within two years. On the other hand, removing a person’s genital warts does not mean that he or she can’t transmit the disease.

Although condoms offer some protection against the spread of HPV, they provide no guarantee against its transmission because they don’t cover the entire genital area.